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New research · Ophthalmology
BMC pediatrics · 12h
Cohort studyBMC pediatrics · 2026

Early surgical intervention for orbital complications of pediatric acute rhinosinusitis: outcomes and algorithmic approach.

Majd Werda, Rania Kharrat, Omar Walha … Ilheme Charfeddine
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OphthalmologyCohort study

Surgery for pediatric orbital complications of sinusitis succeeded in 95.8% of cases.

Early surgical intervention for orbital complications of pediatric acute rhinosinusitis: outcomes and algorithmic approach.

Majd Werda … Ilheme Charfeddine
BMC pediatrics · 2026
Background

Orbital complications of acute rhinosinusitis (acute rhinosinusitis) in children require prompt intervention, but consensus on optimal surgical timing and approach remains limited.

Methods

We conducted a retrospective cohort study of 48 patients aged <15 years who underwent surgery for acute rhinosinusitis-related orbital complications (47 subperiosteal abscesses [SPA], 1 orbital abscess) at a tertiary center.

n = 48 patients
Results

surgery cleared the infection in nearly all children treated

95.8%
Success rate
4.2%
Reoperation rate
More results

Exclusive endonasal drainage was successful in all 8 cases where applied.

No permanent visual deficits or major complications occurred.

Surgical outcomes were independent of preoperative antibiotic heterogeneity, though this variability precluded direct medical-surgical comparisons.

“
Conclusion · 1 of 3

Surgery for pediatric acute rhinosinusitis-related orbital complications achieves excellent outcomes when guided by radiographic and clinical criteria.

Conclusion · 2 of 3

Combined drainage is reserved for extensive abscesses, while endonasal alone suffices for localized cases.

Conclusion · 3 of 3

These findings support a standardized algorithm (Figure 3) integrating abscess location, volume, and clinical progression to optimize care. Future prospective studies should address antibiotic protocol standardization.

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